Table 2.
Response and survival outcomes in the analyzed studies.
| Authors, Year | Median Follow-Up, Months | Criteria for Overlapping between GAS and Anti-cancer Treatment (Time Overlapping %) | Therapeutic Approach, n (%) | ORR | OS HR (95% CI) * | PFS HR (95% CI) * | Type of Analysis | Quality NOS Score |
|---|---|---|---|---|---|---|---|---|
| Ha, 2014 [23] | NA | GAS: 45 (20%) | NA | 1.43 (0.95–2.15) |
1.36 (0.92–2.01) |
UVA | 5 | |
| 100 | No GAS: 186 (80%) | NA | ||||||
| Sun, 2016 [27] | NA | GAS: 77 (26%) | NA | 0.94 (0.49–1.78) |
0.61 (0.34–1.08) |
MVA | 5 | |
| Any PPI prescription | No GAS: 202 (74%) | NA | ||||||
| Chu, 2015 [19] | NA | GAS: 124 (25%) | 5.6% | 1.37 (1.11–1.69) |
1.83 (1.48–2.25) |
MVA | 6 | |
| ≥20 | No GAS: 383 (75%) | 18.5% | ||||||
| Zenke, 2016 [30] | 36 (10.1–85.2) | GAS: 47 (36%) | 64% | 1.41 (0.83–2.35) |
1.15 (0.73–1.79) |
MVA | 7 | |
| PPI/H2RA sequentially or concurrently to anti-EGFR | No GAS: 83 (64%) | 63% | ||||||
| Kumarakulasinghe, 2016 [24] | 50 | GAS: 55 (35%) | NA | 1.37 (0.89–2.12) |
1.47 (0.92–2.35) |
MVA | 7 | |
| ≥30 | No GAS: 102 (65%) | NA | ||||||
| Chen, 2016 [18] | 24.5 | GAS: 57 (21%) | NA | 2.27 (1.26–4.11) |
2.00 (0.96–4.17) |
MVA | 6 | |
| ≥30 | No GAS: 212 (79%) | NA | ||||||
| Graham, 2016 [21] | NA | GAS: 117 (9%) | NA | 1.34 (1.01–1.79) |
NA | MVA | 7 | |
| NA | No GAS: 1187 (91%) | NA | ||||||
| Chu, 2017 [20] | NA | GAS: 119 (44%) | 36% | 1.41 (1.11–1.71) |
1.68 (1.42–1.94) |
MVA | 5 | |
| ≥20 | No GAS: 155 (56%) | 42% | ||||||
| Zhang, 2017 [31] | 66 | GAS: 29 (23%) | 52.2% | 0.30 (0.09–0.99) |
0.37 (0.11–1.23) * |
UVA *, MVA | 7 | |
| ≥200 mg PPI | No GAS: 96 (77%) | 36.5% | ||||||
| Lalani, 2017 [16] | NA | GAS: 120 (5%) | 23.3% | 1.05 (0.77–1.44) |
1.02 (0.79–1.30) |
MVA | 5 | |
| ≥1 dose PPI | No GAS: 2068(95%) | 27.4% | ||||||
| McAlister, 2018 [25] | NA | GAS: 66 (73%) | NA | 0.99 (0.51–1.93) |
1.25 (0.76–2.07) |
MVA | 5 | |
| ≥90 days | No GAS: 24 (27%) | NA | ||||||
| Tvingsholm, 2018 [28] | 1.52 (0.50–3.89) | GAS: 41,218 (11.7%) | NA | 1.29 (1.27–1.31) |
NA | MVA | 7 | |
| ≥2 prescriptions within 6 months | No GAS: 311,853 (88.3%) | NA | ||||||
| Wong, 2019 [29] | NA | GAS: 50 (23.4%) | NA | 1.68 (0.75–3.80) |
2.20 (1.14–4.25) |
MVA | 5 | |
| Any time PPI during capecitabine | No GAS: 164 (76.6%) | NA | ||||||
| Fang, 2019 [21] | NA | GAS: 309 (24%) | NA | 1.67 (1.33–2.09) |
0.99 (0.80–1.23) |
MVA | 7 | |
| ≥20 | No GAS: 969 (76%) | NA | ||||||
| Mir, 2019 [17] | 27.6 (22.9–35.4) | GAS: 59 (18%) | NA | 1.81 (1.31–2.49) |
1.49 (1.11–1.99) |
MVA | 6 | |
| ≥80 | No GAS: 273 (82%) | NA | ||||||
| Sharma, 2019 [26] | NA | GAS: 2843 (22.7%) | NA | 1.10 (1.04–1.17) |
NA | MVA | 8 | |
| ≥30 days within 3 months | No GAS: 9695 (77.3%) | NA |
* When both univariate and multivariate analyses were performed, HR results of multivariate analyses are reported. Legend: CI, confidence interval; GAS, gastric acid suppressants; HR, hazard ratio; NA, not available; NA, not determined; NOS, Newcastle-Ottawa Scale; MVA, multivariate analysis; ORR, overall response rate; OS, overall survival; PFS, progression free survival; UVA, univariate analysis.